The Billing Coordinator oversees the tasks of sending claims to various insurance providers and monitoring outstanding balances to ensure a multitude of provider groups are paid on time and in full. In addition to this meticulous attention to detail, the billing specialist must also possess excellent communication skills to answer questions for providers and clients, solve their issues, and keep them updated with relevant account information.
Responsibilities:
Follow up on all claims past 30 days of age utilizing the EHR system for each individual client. Utilize EHR systems such as but not limited to RXNT, Therapy Notes, Share Note, Office Ally, Availity, Novita Sphere, etc.
Ensure all claims are paid at the correct rate within 60 days of billed service.
Review and submit accurate billing, ERAs, etc.
Check accuracy for charge entry.
Review all EOBs and ERAs sent to Biller with needed corrections such as inappropriate denial, paid wrong rate, correct place of service, or modifier.
Submit CMS 1500s to secondary and tertiary payers within 15 days of receiving denial from primary insurance.
Use online healthcare databases and other resources for verification and claim status.
Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
Submit a weekly update to the Operating Officer of claims activities completed and outstanding items with an action plan for completion. This will be utilized to compare the eligible paid hours.
Answer phone lines throughout the day, take messages.
Communicate via email, phone, or fax with different providers.
Submit prior authorization requests for providers, if needed.
Perform other duties as assigned by management.
Skills:
2 years of proven experience as a billing specialist.
Adherence to laws and best practices regarding dealing with customers and data.
Comfortable dealing with numbers and processing financial information.
Excellent knowledge of MS Office (particularly Excel) and EHR software.
Proficiency in English.
Results-driven.
High degree of attention to detail.
Ability to multitask and manage different agencies' billing.
High school diploma with experience or higher accepted.
Behavioral Health Billing: 2 years (Required)
Work Location: In person